Systematic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma

Wong, Michael; Lee, Jacky; Choy, Bonnie Nga Kwan; Chan, Jonathan C.H.; Lai, Jimmy Shiu Ming

doi:10.1016/j.survophthal.2014.06.006

Cited by 184 publications

(155 citation statements)

References 75 publications

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“…This is probably due to our recruitment, given that we did not exclude patients in advanced stages of the disease or those with a history of filtration surgery. The various prospective and retrospective studies carried out on the efficacy of laser SLT at one year report a percentage reduction in IOP between 16.9 and 31.6% of baseline [9], consistent with our 19.6% decrease in IOP. treated over 360° (p = 0.0024).…”

Section: Data Collectionsupporting

confidence: 89%

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Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

Mathilde¹,

Baptiste²,

Luc³

et al. 2017

Int J Ophthalmol Clin Res

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Purpose: The objective of this study was to observe the 1-year pressure gain in a consecutive series of glaucoma patients treated by selective laser trabeculoplasty, along with the clinical and technical characteristics that influence the evolution of intraocular pressure after treatment. Materials and methods:We carried out a retrospective study of all patients treated in the ophthalmology department of Nancy University Hospital between January 2015 and March 2016. Treatment was performed with a Q-Switched, frequency doubled Nd: YAG laser (Solutis -Quantel Medical, France), over 180° or 360° of the trabecular meshwork. The mean decreases in Intraocular pressure and the success rate (defined as a decrease in intraocular pressure of ≥ 20% at 1 year without increasing the medical treatment) were calculated. The impact of the different clinical and technical characteristics of each case on the decrease in pressure was also studied by bivariate analysis. Results:One hundred and nineteen eyes, in 78 patients, were included. The decrease in IOP at 1 year was in mean of 4.2 mmHg (Standard Deviation = 5.37), and of 19.6% from baseline. The success rate was 46.7%. Only two minor and reversible complications occurred during the follow-up period.Discussion: Selective trabeculoplasty is currently a therapeutic option called-upon at different stages in the progression of glaucoma. The duration of efficacy of this laser therapy, and the retreatment frequency are yet to be defined.

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Section: Data Collectionsupporting

confidence: 89%

“…The reduction in IOP after SLT may be explained, besides the mechanical opening of the trabeculum and the canal of Schlemm, by cellular and biochemical mechanisms favouring the drainage of the aqueous humour [8,9].…”

Section: Resultsmentioning

confidence: 99%

Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

Mathilde¹,

Baptiste²,

Luc³

et al. 2017

Int J Ophthalmol Clin Res

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“…With this in mind, we believe it is reasonable to consider alternative treatments, such as laser therapy, as first-line treatment options (17,28,29) . SLT has a good safety profile, does not rely on patient compliance, and has shown to be at least as effective as topical medications in lowering IOP as an initial treatment (for at least one year) (70)(71)(72) and can be repeated when IOP control is lost over time (19,(46)(47)(48) , possibly allowing patients to remain free of topical medication for years (73,74) . In a chronic disease such as OAG, time is always a key parameter.…”

Section: Commentmentioning

confidence: 99%

Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Freitas¹,

Ushida²,

Almeida³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Although eye drops are frequently used as an initial treatment option for open angle glaucoma (OAG), side effects, and poor adherence, among others, may compromise treatment efficacy. In this scenario, laser trabeculoplasty is an interesting therapeutic option for open angle glaucoma cases. Commonly used for many years as a last alternative prior to glaucoma incisional surgery, laser trabeculoplasty has been changing its indication after the advent of selective laser trabeculoplasty (SLT ). In the current review, we critically evaluated the published data regarding the use of laser trabeculoplasty as a first treatment option for open angle glaucoma patients. Studies using SLT as a first-line treatment have encouraging findings. One-year efficacy results are comparable to those obtained with prostaglandin analogues, with a good safety profile. Although the laser´s effect is known to be transitory, recent data suggest it can be successfully repeated in cases with good response to the first SLT treatment.

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“…Certain studies have revealed that SLT results in a >20% reduction in IOP (7,8). However, SLT treatment is not uniformly effective in all eyes (9,10). Identifying patients who are most likely to benefit from the application of SLT is crucial.…”

Section: Introductionmentioning

confidence: 99%

Positive correlation between blood reflux in Schlemm's canal and the decrease of intraocular pressure after selective laser trabeculoplasty in primary open‑angle glaucoma

et al. 2018

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Abstract. The aim of the present study was to investigate the association between blood reflux in Schlemm's canal (SC) and the decrease of intraocular pressure (IOP) after selective laser trabeculoplasty (SLT) in primary open-angle glaucoma (POAG). To verify this, 35 eyes from 25 POAG patients were enrolled. All eyes underwent 360˚ whole-circle gonioscopy via a three-mirror lens, prior to undergoing 360˚ SLT. The four quadrants of the examined eye were individually compressed by the lens, and the presence of blood reflux in SC after removal of the pressure was recorded. Eyes with no blood reflux in any quadrant were assigned to the negative group, while the others were assigned to the positive group. Patients were evaluated at baseline, at 1 and 2 weeks, and at 1, 3 and 6 months after SLT. The results indicated that in the reflux-positive (21 eyes) and -negative (14 eyes) group, a significant IOP decrease was seen at 1 and 2 weeks, and at 1 and 3 months after SLT as compared with that pre-SLT IOP (P<0.01). In the negative group, the IOP at 6 months after SLT was not significantly different (P>0.05), while the positive group still exhibited a significant decrease in IOP compared with that at baseline (P<0.01). The positive group also presented with a greater decline in IOP at 1, 3 and 6 months compared with that in the negative group (P<0.05). A positive correlation between the number of quadrants with blood reflux in SC and the percentage decrease in IOP after SLT was identified in the positive group (P<0.05). In conclusion, blood reflux in SC was positively correlated with the decrease in IOP after SLT in POAG (Trialapproval number, K-2014-013).

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Systematic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma

Cited by 184 publications

References 75 publications

Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

Selective laser trabeculoplasty as an initial treatment option for open-angle glaucoma

Positive correlation between blood reflux in Schlemm's canal and the decrease of intraocular pressure after selective laser trabeculoplasty in primary open‑angle glaucoma

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